| Name: | S. Clint Hudson, D.M.D., M.D., L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 May 2006 (18 years ago) |
| Entity Number: | 000-479-533 |
| Register Number: | 000479533 |
| Historical Names: |
Hudson & Hudson, L.L.C.
Clint Hudson, D.M.D., L.L.C. |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 2317 WHITESBURG DRHUNTSVILLE, AL 35801 |
| Registered Office Street Address ZIP Code: | 35801 |
Activities
PROVIDE ORAL/MAXILLOFACIAL SURGERY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164448320 | 2006-07-14 | 2013-09-03 | 2317 WHITESBURG DR S, HUNTSVILLE, AL, 358013819, US | 2317 WHITESBURG DR S, HUNTSVILLE, AL, 358013819, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 256-533-1282 |
| Fax | 2565331288 |
Authorized person
| Name | S CLINT HUDSON |
| Role | OWNER |
| Phone | 2565331282 |
Taxonomy
| Taxonomy Code | 1223S0112X - Oral and Maxillofacial Surgery (Dentist) |
| License Number | 5051 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | UNITED CONCORDIA |
| Number | 001858654 |
| State | PA |
| Issuer | MEDICAID |
| Number | 529928780 |
| State | AL |
| Issuer | MEDICARE |
| Number | K919 |
| State | AL |
| Issuer | BLUECROSS BLUESHIELD AL |
| Number | 51003400 |
| State | AL |
| Issuer | BLUECROSS BLUESHIELD TN |
| Number | 4129232 |
| State | TN |
| Issuer | BLUECROSS BLUESHIELD AL |
| Number | 51136356 |
| State | AL |
| Name | Role |
|---|---|
| HUDSON, STEVEN CLINT | Agent |
| Name | Role |
|---|---|
| HUDSON, STEVEN CLINT | Member |
| HUDSON, GARY W | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2008-07-01 | Name Change | Clint Hudson, D.M.D., L.L.C. | S. Clint Hudson, D.M.D., M.D., L.L.C. |
| 2008-06-24 | Name Change | Hudson & Hudson, L.L.C. | Clint Hudson, D.M.D., L.L.C. |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
